Utilization Management / Authorizations  

Simplify Utilization Management in Mental Health with PIMSY’s Powerful Authorization Mode

For services that require authorization (sometimes called “pre-auths”) to perform and receive reimbursement, PIMSY EHR is unmatched in utilization management (authorization) module functionality. Handling this process manually can lead to workflow challenges, inefficiencies, and denials. Whether your authorization needs are handled via Managed Care with bundled services or the more traditional “date and unit limits” auth, PIMSY will meet your needs and improve workflows.

PIMSY streamlines the authorization process, reducing errors and improving compliance, allowing providers to focus more on patient care. Our utilization management functionality is a powerful tool that automatically deducts units, based on your pre-defined decrements, when services are performed while prohibiting services outside of that authorization’s limitations (date range, billing code, units, etc.). It provides a structured and efficient system while decreasing denials and administrative burdens.

Authorizations Functionality in PIMSY

PIMSY’s software platform boasts robust functionality, seamlessly automating authorizations, enabling bulk additions, utilizing authorization groups, providing a global authorization screen, enhancing operational efficiency, and facilitating superior mental health care delivery.

Key Advantages: 

• Centralized Authorization Management – centralizes authorization management, allowing easy access and tracking from a single platform while enabling a clear overview of each client’s authorization status.

• Real-time Authorization Status Updates – provides real-time authorization status updates, enabling informed treatment planning decisions.

• Alerts and Reminders – automated alerts notify when authorizations are approaching expiration or running low on units, avoiding treatment interruptions and enabling timely renewal requests.

• Audit Trail – maintains an audit trail of authorization-related activities.

• Reporting and Analytics – reporting and analytics to analyze data trends, identify areas for improvement, and optimize authorization workflows.

• Bulk Management – add or update billing codes in bulk by patient, payer, clinician, etc.

• Authorizations Groups – authorization group functionality allows the system to decrement units from a group of billing codes rather than from each individual code.

• Global Authorization Screen – global management screen allowing view of all authorizations that can be easily filtered or exported, including a quick “at a glance” view of upcoming expirations and auths running low on units.

Conclusion

Utilization management in PIMSY increases operational efficiency, reduces denials, and enhances mental health care delivery. The structured and integrated approach ensures mental health professionals can focus more on patient care and less on administrative tasks.